Exam 1 Flashcards
3 important ramifications when defining a disorder: this colors the way we may interpret behavior
- insurance (reimbursement for treatment)
- legal responsibility for treatment
- disability
3 examples of past and present diagnoses that have been controversial:
- drapetomania (propensity of slaves to run away)
- childhood masturbation disorder
- homosexuality
why is there no single definition of psychological abnormality or normality?
most behaviors exist on a continuum (substance use, sleep, eating, etc.)
wakefield argues disorder as ____
“harmful dysfunction”
hybrid of “value judgment” (ex. harmful) and “biological disadvantage” (a failure of a mechanism to perform naturally)
harmful dysfunction
wakefield’s 5 approaches to defining abnormal behavior: “disorder as ____”
- pure value concept
- whatever professionals treat
- statistical deviance (intellectual disability)
- biological disadvantage (evolution)
- distress or suffering
judgment of desirability according to social norms and ideals
disorder defined as a pure value concept
problem with defining disorder as a pure value concept:
very subjective
2 problems with defining disorder as whatever professionals treat:
- clients come in for treatment for behaviors that are normal
- individuals do NOT come in when they are disordered
-can be statistically deviant on many traits and it is a positive attribute (ex. IQ, strength)
-even undesirable behaviors that are statistically deviant may not be a disorder (ex. being rude)
problem with defining disorder as a statistical deviance (intellectual disability)
- if behavior results in lower reproductive fitness
- if some mental mechanism is not performing the specific function it was designed to perform (ex. normal anxiety vs. pathological anxiety)
- when a mechanism fails to perform as it was designed AND it causes impairment
3 criteria for a disorder to be classified as a biological disadvantage
toward a definition of abnormal behavior:
breakdown in cognitive, emotional, or behavioral function within the individual (it comes from the inside, aka within)
psychological dysfunction
toward a definition of abnormal behavior:
difficulty performing appropriate and expected roles
-some disorders may emphasize one over the other (ex. antisocial personality disorder)
personal distress or disability (functional impairment)
toward a definition of abnormal behavior:
reaction to abnormal behavior is outside cultural norms
atypical or unexpected cultural response
widiger argues that two constructs are fundamental to the definition of mental disorder:
dyscontrol and maladaptively
“an impaired ability to direct or regulate ovolition, emotion, behavior, or cognition, or some other area, which often entails inability to resist impulses and leads to abnormal behaviors without significant provocation” (APA)
dyscontrol
“a condition in which biological traits or behavior patterns are detrimental, counterproductive, or otherwise interfere with optimal functioning in various domains, such as successful interaction with the environment and effectual coping with the challenges and stresses of daily life” (APA)
maladaptively
true or false: some argue that we will never have a perfect definition of a mental disorder
true
a widely accepted system that is used to classify psychological disorders and problems
DSM-5
DSM stands for:
diagnostic and statistical manual of mental disorders
the DSM-5 contains diagnostic criteria for behaviors that: (4)
- fit a pattern
- cause dysfunction or stress
- are present for a specified duration
- are based on protoypes
a typical or standard example of a disorder
prototype
a clinical description of abnormality begins with the ____
presenting problem (what is bringing the client/patient into treatment)
this description aims to distinguish clinically significant dysfunction from common human experience and to describe demographics, relevant symptoms, age of onset, and precipitating factors
clinical description
keep in mind three factors while using the clinical description of abnormality:
- prevalence and incidence
- course of disorders
- onset of disorders
number of people in the population with a disorder
prevalence
number of new cases during a given time
incidence
course of disorders can be ___, ___, or ___
episodic, time-limited, or chronic
onset of disorders can be ___ or ___
acute (comes on quickly)
or insidious (comes on slowly)
factors that contribute to the development of psychopathology
etiology (diathesis-stress model)
combination of risk and a stressor - psychological disorders result from an interaction between inherent vulnerability and environmental stressors
diathesis-stress model
treatment development - how can we help to alleviate psychological suffering?
pharmacologic, psychosocial, and/or combined treatments
studies the effectiveness of clinical interventions, including the comparison of competing treatments
treatment outcome research
treatment outcome research - how do we know that we have helped?
we are limited in specifying actual causes of disorders
major psychological disorders have existed in all ____ and across all ____
cultures ; time periods
two types of antipsychotics came out in the ____ and revolutionized medicine in psychology
1950s
three dominant traditions regarding abnormal behavior include:
- supernatural
- biological
- psychological
in the past, with respect to the supernatural tradition, deviant behavior was viewed as ____ vs. ____
good vs. evil
in the past, with respect to the supernatural tradition, deviant behavior was thought to be caused by:
demonic possession, witchcraft, and sorcery
in the past, with respect to the supernatural tradition, deviant behavior was treated by means of:
exorcism, torture, beatings, and crude surgeries
some treatments that worked in the past during the supernatural tradition:
placebo, classical conditioning, and fear
other worldly causes of deviant behavior:
movement of the moon and stars (astrology)
-“lunacy” is derivative of “luna,” or “moon”
people have long looked for physical causes of psychological disorders
the past: the biological tradition
who is the father of modern medicine?
hippocrates
____ believed that psychological disorders could be treated like any other disease. he believed “disease” was not the only potential cause, but that head trauma, brain pathology, and hereditary could impact disorders
hippocrates
____ extended hippocrates’ work, creating the ____ theory of mental illness
galen ; humoral theory of mental illness
the idea that disease resulted from having too much or too little of a certain humor
humoral theory of mental illness
the humoral theory of mental illness is comprised of 4 major bodily fluids, or “humors” :
- blood (heart)
- black bile (spine)
- yellow bile (liver)
- phlegm (brain)
this tradition linked abnormality with brain chemical imbalances and foreshadowed modern views
galenic-hippocratic tradition
the biological condition comes of age:
interest in biological factors of mental illness fluctuated over the centuries until the 19th century. what happened to bolster the view that mental illness = physical illness, providing a biological basis for madness?
syphilis
a sexually transmitted disease caused by a bacterial infection
syphilis
advanced stage syphilis can result in ___ and ___
delusions and other psychotic behaviors (hallucinations)
who discovered the cause of syphilis, and what was the cause he discovered?
pasteur ; a bacterial microorganism
pasteur’s discovery that syphilis was caused by a bacterial microorganism led to ____ as a successful treatment
penicillin
the biological tradition led to ___ treatments
biological
during this time, biological treatments were standard practice (insulin shock therapy, ECT, and brain surgery)
the 1930s
during this time, medications (such as neuroleptics aka antipsychotics) were becoming increasingly available
the 1950s
this medication reduces hallucinations, delusions, agitation, and aggressiveness
neuroleptics (antipsychotics)
during this time, benzodizepines (ex. valium) were introduced, and antidepressants began being developed
1970s
the past: the psychological tradition
plato and aristotle both thought that the ____ and ____ environment and ____ experiences impacted psychopathology
social and cultural environment ; early learning experiences
normalizing treatment of the mentally ill
-reinforce and model appropriate behaviors
-emphasize importance of a nurturing environment
the rise of moral therapy
- worked best with smaller patient populations
- dorothea dix led the mental hygiene movement
- rise of mental hygiene movement - move from moral therapy to “custodial care”
- rise of biological tradition and notion that mental illness was due to brain pathology and was incurable
4 reasons for the falling out of moral therapy:
the psychological tradition reemerges in the 1900s in three different forms:
- psychoanalysis
- humanism
- behaviorism (and cognitive-behaviorism eventually)
the past: the psychoanalytic tradition was led by ___ and ___
freud and breuer
the past: the psychoanalytic tradition
breuer had patients describe psychological problems and conflicts under hypnosis, leading to two important “discoveries” :
unconscious mind and catharsis
under hypnosis, individuals revealed material that appeared to be outside of their explicit awareness
unconscious mind
individuals felt better after discussing and reliving emotionally painful events and feelings (release of emotional tension)
catharsis
unconscious needs or drives are at the heart of human motivation
-human behavior is influenced by unconscious memories, thoughts, and urges
freudian theory
structure and function of the mind (3 components)
- id
- ego
- superego
think of the ___ as the brain, the ___ as the devil on your shoulder, and the ___ as the angel
-ego as the brain
-id as the devil on your shoulder
-superego as the angel
the pleasure principle (demands immediate gratification)
id
the most primitive part of the mind (part of the mind that is “like a four year old”)
id
unique processing of information within the id
primary process
thinking that is emotional, irrational, fantastical, and primal (sex, aggression, and envy)
primary process
the id is the source of sexual and aggressive motives and “energy,” which freud called ____
libido
instinctual drive for sex, pleasure, and fulfillment
eros
the “death instinct” - drive toward aggression and death
thanatos
the reality principle; must balance the needs of the id with rules of society
ego
the thinking style associated with the ego is called
secondary process
secondary process within the ego is characterized by ___ and ___
logic and reason
ego referred to as a rider on a horse (the horse being id)
the horse is stronger, but the man can usually control it
conscience - represents the moral ideas we learn from family, friends, and society
superego
how does our superego develop?
as a result of being rewarded and punished for various behaviors (or seeing others experience this via vicarious learning)
the purpose of the superego is to:
counteract the drive toward sex and aggression offered by the id
____ must mediate between the id and superego
ego
if mediation between the id and the superego is successful…
individuals can pursue higher goals
if mediation between the id and the superego is not successful… (if either the id or superego is overpowering)
we will experience intrapsychic conflict (an over-controlling superego can cause just as many problems as an over-controlling id)
freud felt that ___ and ___ were almost entirely unconscious
id and superego
when ego cannot maintain balance between the needs of id and superego, it results in ___
anxiety
anxiety serves as a warning that ego might be overwhelmed - results in use of ____
defense mechanisms
unconscious protective processes that keep primitive emotions associated with conflict in check so that the ego can continue with its coordinating function
defense mechanisms
defense mechanisms can be ____ or ____ (some call them “coping styles”)
adaptive or maladaptive
8 defense mechanisms:
- affiliation
- humor
- sublimation
- displacement
- intellectualization
- reaction formation
- repression
- projection
deal with conflict by turning to others for help and support
affiliation
emphasize the amusing or ironic aspects of conflict or stressor
humor
deal with conflict or stressors by channeling potentially maladaptive feelings or impulses into socially acceptable behavior
sublimation
ex. of sublimation as a defense mechanism:
someone with anger issues may channel their aggressive urges into sports instead of lashing out at others physically or verbally
transfer feelings about, or response to, one object onto another (usually less threatening) substitute object
displacement
ex. of displacement as a defense mechanism
a person who is angry at their boss may “take out” their anger on a family member by shouting at them
excessive use of abstract thinking or the making of generalizations to control or minimize disturbing feelings
intellectualization
ex. of intellectualization as a defense mechanism
a person might focus on funeral arrangements rather than dealing with their own grief, or spending all of their time researching an illness they have been diagnosed with, rather than talking about how they feel about the diagnosis
substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones
reaction formation
ex. of reaction formation as a defense mechanism
a young boy who bullies a young girl because, on a subconscious level, he is attracted to her
blocks disturbing wishes, thoughts, or experiences from conscious awareness
repression
falsely attributing own unacceptable feelings, impulses, or thoughts to another individual
projection
ex. of projection as a defense mechanism
the classroom bully who teases other children for crying but is quick to cry
stages of child development in which a child’s pleasure-seeking urges are focused on specific areas of the body called erogenous zones
psychosexual stages of development
freud posited 5 basic stages of psychosexual stages of development
- oral stage
- anal stage
- phallic stage
- latency stage
- genital stage
inadequate or inappropriate gratification in any stage would lead to a “____,” which would be reflected in the individual’s adult behavior
“fixation”
the oral stage occurs from ___ to age ___ to ___
birth to age 1.5 to 2
the oral stage is characterized by a central focus on ____ (sucking; lips, tongue, and mouth become focus of pleasure)
food
ex. of an oral fixation
smoking or chewing on something
the anal stage occurs from age ___ to ___
2 to 3
the anal stage is characterized by a central focus on the ____ and the ____ vs. ____ of feces
anus ; expulsion vs. retention
the anal stage is resolved when:
toilet training is completed
ex. of anal fixation
anal retentive (OCD, “you’re so anal”)
anal explosive (sloppy, disorganized, “out-there”)
the phallic stage occurs from age ___ to ___ or ___
3 to 5 or 6
the phallic stage is characterized by a focus on the ___ region
genital region ; as the child becomes more interested in his genitals, and in the genitals of others
2 major conflicts during the phallic stage:
oedipus complex and electra complex
young boys have sexual fantasies tied to interactions with mother
oedipus complex
the oedipus complex leads to anger toward the father because they see father as an obstacle, but fears father - results in identification with father
castration anxiety
young girls want to replace mother and possess father
electra complex
girls desire a penis, so as to be more like father (resolved when girls develop a healthy heterosexual relationship)
penis envy
the latency stage occurs from age ___ or ___ until ___
5 or 6 until puberty
sexual interest lies ___ during the latency stage, and energy (___) is put into nonsexual interests, such as friendships, school, sports, and play
dormant ; libido
the genital stage occurs during ____
puberty
during the genital stage, the central focus returns to the ____ and interest in sexual relationships ____
genitals ; increases
freud believed that progress during the genital stage was ____ if the child remained fixated at earlier stages
impeded
the purpose of this therapy is to unearth the hidden intrapsychic conflicts through catharsis and insight (focus on childhood)
psychoanalysis
psychoanalysis is ____ (2-5 years) and high ____ (3-5 times per week)
long-term ; high frequency
-to analyze and resolve conflicts
-to restructure personality
-focus is NOT on symptom reductive
-ambitious goals - are issue focused
goals of psychotherapy
-patient lies on couch, analyst sits behind couch
-free association - no censoring!
-dream analysis - content reflects primary process (id)
examine transference and counter-transference issues
psychoanalysis techniques
the key to psychoanalysis - ____ is good
transference
projecting onto the therapist the conflicts/issues one has in a stable way
transference
this occurs when the therapist projects their own unresolved conflicts onto the client
counter-transference
issue with psychoanalysis
efficacy data are limited
this theory focuses on affect and patient’s expression of emotions (may comment on; more reflection back)
psychodynamic theory
nonverbal expressions of emotion
affect
-explore patients’ avoidance of topics or decisions to engage in behaviors that hinder therapy
-identify patterns in patients’ behaviors, thoughts, and feelings (personality)
-emphasis on role of past experiences
-focus on interpersonal experiences
-emphasis on therapeutic relationship
-exploration of patients’ fantasies, dreams, and wishes
characteristics of psychodynamic theory
common factor in therapy: whether you like your therapist, can trust your therapist, etc. determines outcome of therapy (whether or not one will get better)
therapeutic alliance
notion that there was a positive, uplifting quality of humanity (humans as beings that strive for improvement and excellence)
- much more optimistic notion (gives humans the benefit of the doubt)
humanistic theory
